<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('新增病例发现与就诊信息')" />
    <th:block th:include="include :: datetimepicker-css" />
</head>
<body class="white-bg">
    <div class="wrapper wrapper-content animated fadeInRight ibox-content">
        <form class="form-horizontal m" id="form-CaseDiscoveryTreatment-add">
            <div class="form-group">    
                <label class="col-sm-3 control-label">病例ID：</label>
                <div class="col-sm-8">
                    <inputname="caseid"  class="form-control" type="text"   readonly="readonly">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">病例发现途径：</label>
                <div class="col-sm-8">
                    <input name="discoveryWay"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">其他途径：</label>
                <div class="col-sm-8">
                    <input name="otherWay"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">入院日期：</label>
                <div class="col-sm-8">
                    <div class="input-group date">
                        <input name="admissionDate" class="form-control" placeholder="yyyy-MM-dd" type="text">
                        <span class="input-group-addon"><i class="fa fa-calendar"></i></span>
                    </div>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">入院时症状和体征：</label>
                <div class="col-sm-8">
                    <input name="symptomsAndSigns"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">其他症状和体征：</label>
                <div class="col-sm-8">
                    <input name="otherSymptoms"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">并发症：</label>
                <div class="col-sm-8">
                    <input name="complication"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">其他并发症：</label>
                <div class="col-sm-8">
                    <input name="otherComplication"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">CT：</label>
                <div class="col-sm-8">
                    <input name="ifImagingFeatures"  class="form-control" type="text"  required="required">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">检查日期：</label>
                <div class="col-sm-8">
                    <div class="input-group date">
                        <input name="checkupDate" class="form-control" placeholder="yyyy-MM-dd" type="text">
                        <span class="input-group-addon"><i class="fa fa-calendar"></i></span>
                    </div>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">出院日期：</label>
                <div class="col-sm-8">
                    <div class="input-group date">
                        <input name="dischargeDate" class="form-control" placeholder="yyyy-MM-dd" type="text">
                        <span class="input-group-addon"><i class="fa fa-calendar"></i></span>
                    </div>
                </div>
            </div>
        </form>
    </div>
    <th:block th:include="include :: footer" />
    <th:block th:include="include :: datetimepicker-js" />
    <script th:inline="javascript">
        var prefix = ctx + "system/CaseDiscoveryTreatment"
        $("#form-CaseDiscoveryTreatment-add").validate({
            focusCleanup: true
        });

        function submitHandler() {
            if ($.validate.form()) {
                $.operate.save(prefix + "/add", $('#form-CaseDiscoveryTreatment-add').serialize());
            }
        }

        $("input[name='admissionDate']").datetimepicker({
            format: "yyyy-mm-dd",
            minView: "month",
            autoclose: true
        });

        $("input[name='checkupDate']").datetimepicker({
            format: "yyyy-mm-dd",
            minView: "month",
            autoclose: true
        });

        $("input[name='dischargeDate']").datetimepicker({
            format: "yyyy-mm-dd",
            minView: "month",
            autoclose: true
        });
    </script>
</body>
</html>